Declaration

The undersigned, being a duly authorized representative of the Company, represents and declares that:

1. The Company and its Management1 have not been found guilty pursuant
YES NO
to a final judgment or a final administrative decision of any of the following:

a. Fraud;

b. Corruption;

c. conduct related to a criminal organisation;

d. money laundering or terrorist financing;

e. terrorist offences or offences linked to terrorist activities;

f. sexual exploitation and abuse;

g. child labour, forced labour, human trafficking; or

h. irregularity (non-compliance with any legal or regulatory

requirement applicable to the Company or its Management).

2. The Company and its Management have not been found guilty pursuant
to a final judgment or a final administrative decision of grave professional
misconduct.

3. The Company and its Management are not: bankrupt, subject to

insolvency or winding-up procedures, subject to the administration of
assets by a liquidator or a court, in an arrangement with creditors, subject
to a legal suspension of business activities, or in any analogous situation
arising from a similar procedure provided for under applicable national
law.

4. The Company and its Management have not been the subject of a final
judgment or a final administrative decision finding them in breach of their
obligations relating to the payment of taxes or social security
contributions.

5. The Company and its Management have not been the subject of a final
judgment or a final administrative decision which found they created an
entity in a different jurisdiction with the intent to circumvent fiscal, social
or any other legal obligations in the jurisdiction of its registered office,
central administration, or principal place of business (creating a shell
company).

6. The Company and its Management have not been the subject of a final
judgment or a final administrative decision which found the Company was
created with the intent referred to in point (5) (being a shell company)

1 “Management” means any person having powers of representation, decision-making or control over the Organization. This
may include, for example, executive management and all other persons holding downstream managerial authority, anyone on
the board of directors, and controlling shareholders.
The UNICEF reserves the right to disqualify the Company suspend or terminate any contract or other arrangement
between the UNICEF and the Company, with immediate effect and without liability, in the event of any
misrepresentation made by the Company in this Declaration.

It is the responsibility of the Company to immediately inform the UNICEF of any changes in the situations declared.

This Declaration is in addition to, and does not replace or cancel, or operate as a waiver of, any terms of contractual
arrangements between the UNICEF and the Company.

Signature: ____________________________________________________
Date: ____________________________________________________
Name and Title: ____________________________________________________
Name of the Company: ____________________________________________________
UNGM #: ____________________________________________________
Postal Address: ____________________________________________________
Email: ____________________________________________________